以发热为主要表现的肝癌的诊断与治疗:附10例分析

Diagnosis and treatment of hepatocellular carcinoma with fever as main symptom: a report of 10 cases

目的:探讨以发热为主要表现的肝癌的诊断与治疗方法。方法:回顾性分析近期收治的10例以发热为主要表现的肝癌患者的临床资料。结果:10例中4例在外院诊断为肝癌,6例误诊为肝脓肿,予以抗感染治疗较长时间。患者入院后经积极支持治疗,并良好控制体温,6例行经皮肝动脉插管化疗栓塞(TACE)治疗,4例行手术治疗,1例术后2周死亡。9例随访结果提示总体预后不佳,均于治疗后2个月至1年内死亡。结论:以发热为主要表现的肝癌应与肝脓肿相鉴别。对于此类患者,首选手术切除。

Objective： To investigate the diagnosis and treatment of hepatocellular carcinoma（HCC） with fever as main symptom. Methods： The clinical data of 10 HCC patients with fever as main symptom recently admitted to our hospital were retrospectively analyzed. Results： Of the 10 patients,4 cases were diagnosed with HCC,but 6 cases had been misdiagnosed as liver abscess by other hospitals and were given anti-infective treatment for a long time.All of the patients received aggressive management and their temperatures were effectively controlled after admission.Six patients underwent transcatheter arterial chemoembolization（TACE） and 4 patients underwent surgical treatment.One patient died 2 weeks after surgery.The follow-up data suggested a poor general prognosis.The other 9 cases died between 2 months and 1 year after treatment. Conclusion： HCC with fever as main symptom should be differentiated from liver abscess,and surgical resection is the first choice for treatment of these patients.